The present invention generally relates to the Ponseti method (also known as the Ponseti technique), a non-surgical technique that uses a series of casts, followed by an abduction brace, or ankle foot orthosis (AFO), to correct congenital clubfoot. The condition causes a baby's feet to turn inward and downward; if not corrected, the child will be unable to walk or move properly. Page 454 of the Atlas of Orthoses and Assistive Devices by Hsu, Michael and Fisk; American Academy of Orthopaedic Surgeons includes the following section.                Various orthoses are used for treatment of clubfoot. Most often, the orthosis is used as a holding device after correction by nonoperative or surgical methods. Typically a more restrictive orthosis is used initially on a full-time schedule. Once the child begins to crawl and/or walk, different bracing regimens for daytime and sleeping can be prescribed.        Scarpa in 1803 gave the first detailed description of an orthosis for treatment of clubfoot. The device was an AFO with metal upright bars and cuffs at the proximal calf and the malleoli, with a cup gripping the hindfoot. The orthosis produced a pronation and an abduction moment at the forefoot.        
The Denis Browne bar, also known as the Denis Browne splint or foot abduction orthosis, is a medical device which, and/or variations of it, have been successfully used for decades as part of the Ponseti method. In 1934, Denis Browne described a treatment which included taping the feet onto a bar to maintain the position obtained by manipulation. Modern variations include the Ponseti® abduction bar commercially available from www.mdorthopaedics.easyordershop.com.
In US Patent Application Publication US 2013/0226059 A1, inventor Phillip Morris describes an AFO which is independently worn on a foot and leg of a patient without a connection to a Denis Browne bar connecting the feet. This “bar-less” brace was configured with two spring loaded joints to permit movement while urging the foot to return to a predetermined therapeutic orientation. A Morris AFO could be used on one or both feet.
While the Morris AFO is enjoying some success, it has a drawback in that the springs which provide the biasing forces to urge return of the foot to the therapeutic orientation may need to be adjusted, replaced or exchanged, which can require a considerable amount of strength, degree of skill and labor.
Consequently, there exists a need for AFOs which, among other things, avoid the need for springs or at least some of the skill, strength and time required for making changes to the spring.